Involving medical students in re-orienting health services: a photovoice study.


health promotion
reorienting health services
qualitative research
medical education



Introduction. Health promotion healthcare reorientation aims for health services focused not exclusively on diseases but also on prevention and health promotion. The implementation depends strongly on professionals’ willingness to actively participate in the reorientation. An effective strategy to boost reorientation is to reorient education and role definition of future professionals.

This paper examines whether photovoice, a qualitative research method, can be suitable to i) increase future health professionals’ awareness of users’ needs and expectations; and ii) enable a process of critical reflection on role definition and health services organisation.

Methods. One hundred and seventy-two medical students participated in the photovoice project. Participants were asked to produce one photo combined with an accompanying caption, responding to a pre-identified question: “What is, in your opinion, the main aspect affecting users' satisfaction/dissatisfaction in a healthcare facility?”. Participants discussed their photos in group discussions (n=16) and participated in data analysis sessions (n=4).

Results. Participants' contributions revolved around how services were delivered (e.g., kindness, accessibility, attention to additional needs) rather than the service provided. The students showed their empathic side and proposed smart and inclusive solutions to improve users' overall experience. The proposals often implied a change in behaviour of professionals -their future selves- towards patients and low-cost improvements of organisational practices.

Conclusions. This study demonstrated the value of using photovoice to reach medical students to integrate health promotion into their professional identities. The photovoice process, teamwork, and discussions opened a breach into traditional thinking about healthcare aspects often taken for granted or overlooked.  Our results confirm that a mix of advanced education and community-based participatory research activities has the potential to produce medical doctors responsive to users’ needs. This low-cost strategy should be considered for future interventions aimed at reorienting healthcare.


Dr Stefanie Buckner

Public Health Specialist at Southwark Council and Honorary Senior Research Fellow at Cambridge University

Qualitative research and photovoice expertise

Dr Calum Mattocks

Cambridge University

Research Associate

Qualitative research and photovoice expertise

Dr Suzanne Rotheram

Research Associate

University of Liverpool

Qualitative expertise in the field of public health research.

Dr. Anna Bonmatí Tomàs

Associate Professor of Nursing Department in University of Girona

University of Girona

Expertise in health professionals’ education, health promotion, salutogenesis.